JP2012532664A5 - - Google Patents

Description

Hip device and method

  The present invention relates generally to hip prosthesis.

  Hip osteoarthritis is a syndrome caused by abnormal wear of cartilage that acts as a cushion inside the hip joint, and its low degree of inflammation causes hip pain. This abnormal wear of the cartilage also results in the reduction of joint lubricating fluid called synovial fluid. Hip osteoarthritis is estimated to affect 80% of all people over the age of 65 (even if the severity varies).

  Current treatments for hip osteoarthritis include NSAIDs, topical injection of hyaluronic acid or glucocorticoids to aid in the smoothness of the hip joint, and replacement of the hip joint with part of the hip joint prosthesis, etc. There is.

The replacement of the hip joint is one of the most commonly performed operations that hundreds of thousands of people receive worldwide each year. The most common method is to place a metal prosthesis on the femur and a plastic bowl on the acetabulum. The operation is a lateral incision in the hip and upper thigh and through the fascia lata and the lateral muscles of the thigh. It is necessary to penetrate the supporting hip joint attached to the femur and iliac to gain access to the joint. The femur is then cut at the neck with a bone saw and the prosthesis placed on the femur with or without cement. The acetabulum is slightly expanded using an acetabular reamer, and the plastic bowl is put in place using a screw or bone cement.

  Metal prostheses placed in the femur are usually harder than human bone and therefore often cause injuries to the femur in that the prosthesis is fixed to the femur. The difference in elasticity between the femoral and hip prostheses also affects the fixation of the prosthesis. Prosthetic relaxation is the most common reason that requires hip surgery and the difference in elasticity between the prosthesis and the femur creates tension at the fixation point, which promotes the prosthetic relaxation.

  A further problem with stiff or non-elastic prostheses is that the prosthesis completely takes over the loads transmitted from natural bones. Because of that, the bone recedes and the formation of new bone tissue is reduced. Finally, this process extends the relaxation of the prosthesis. Strain on the contact surface also results from shocks transmitted to the body from normal walking. Also, larger and wider distortions result from accident situations such as falls. Hard prostheses do not have a shock absorbing action, so the total shock is transmitted to the contact surface that secures the prosthesis to the femur.

  It is therefore desirable to have a hip prosthesis that has elastic properties similar to bone in that it fixes the prosthesis to the bone. It is desirable to have a hip joint prosthesis that absorbs shock in a similar or improved manner as and / or a natural hip joint.

  A hip prosthesis is provided for implantation and attachment to the hip joint of a human patient. The hip joint prosthesis comprises a first region and a second region, the first region comprising a first material or a part thereof attached for increased elasticity, and the second region attached for increased elasticity It consists of a 2nd material or its part. The first material or portion thereof is attached such that it is more resilient than the second material or portion thereof.

  According to one embodiment, the hip prosthesis comprises first and second ends located on the longitudinal axis of the hip prosthesis. The first end comprises the first material or part thereof and the second end comprises the second material or part thereof. When implanting a hip prosthesis into the human patient, the proximal portion of the hip prosthesis comprises the first end and the distal end of the hip prosthesis comprises the second end.

  According to one embodiment, the hip prosthesis gradually increases in elasticity from the second end to the first end.

  According to another embodiment, the hip prosthesis further comprises a third, fourth and fifth area, the third area comprises the third material or part thereof and the fourth area comprises the fourth material or part thereof And the fifth region consists of the fifth material or part thereof. The first, second, third, fourth and fifth materials or parts thereof are bonded to one another through net attraction.

  According to one embodiment, the first material or part thereof is attached so as to be more elastic than the second material or part thereof, and the second material or part thereof is from the third material or part thereof The third material or a part thereof is attached so as to be more elastic than the fourth material or a part thereof, and the fourth material or a part thereof is a fifth material or a part thereof It is attached so that elasticity is larger than a part.

  According to one embodiment, the first material or part thereof is attached to be more elastic than the second material or part thereof and the second material is attached to be more elastic than the third material And the third material or part thereof is attached so as to be less elastic than the fourth material or part thereof, and the fourth material or part thereof is less elastic than the fifth material or part thereof To be installed.

  According to one embodiment, the first material or part thereof is attached so as to be more elastic than the second material or part thereof, the second material being more elastic than the third material or part thereof And the third material or part thereof is attached to be more resilient than the fourth material or part thereof, and the fourth material or part thereof is a member of the fifth material or part thereof It is attached so that elasticity is smaller than that.

  According to one embodiment, when implanting the hip prosthesis into the human patient, the first region is the most proximal region among the first, second, third, fourth and fifth regions. And the second region is the second proximal region among the first, second, third, fourth and fifth regions, and the third region is the first, second, third, fourth and fifth regions. The third and fourth proximal regions among the fourth and fifth regions, and the fourth proximal region among the first, second, third, fourth, and fifth regions. , And the fifth area is the fifth proximal area among the first, second, third, fourth, and fifth areas.

  According to one embodiment, the first material or part thereof is attached so as to be more elastic than the second material or part thereof, and the second material or part thereof is from the third material or part thereof The third material or part thereof is attached to be more elastic than the fourth material or part thereof, and the fourth material or part thereof is a fifth material or It is attached in such a way that its elasticity is greater than a part of it.

  According to one embodiment, the first material or part thereof is attached so as to be more elastic than the second material or part thereof, and the second material or part thereof is from the third material or part thereof The third material or a part thereof is attached so as to be less elastic than the fourth material or a part thereof, and the fourth material or a part thereof is a fifth material or It is attached so that elasticity is smaller than that part.

  According to one embodiment, the first material or part thereof is attached so as to be more elastic than the second material or part thereof, and the second material or part thereof is from the third material or part thereof The third material or part thereof is attached to be more elastic than the fourth material or part thereof, and the fourth material or part thereof is a fifth material or It is attached so that elasticity is smaller than that part.

  According to one embodiment, the first, second, third, fourth and fifth materials or all of them, in any combination, consist of different materials or different parts of the same material. Here, all materials or different parts of the materials all have different elasticity.

  The hip joint further comprises an acetabulum, which is a bowl-shaped portion of the pelvis. The hip prosthesis further comprises a connecting area consisting of a connecting surface. The bonding surface comprises a first surface material or a portion thereof having an average elasticity. Here, the surface is attached to bond with the acetabulum or its artificial substitute. The hip prosthesis further comprises a fixation zone consisting of a fixation surface. A fixation surface comprised of a second surface material having an average elasticity, or a portion thereof, is attached to assist in the fixation of the hip prosthesis to the femur of the human patient.

  According to one embodiment, the average elasticity of the first surface material or part thereof is lower than the average elasticity of the second surface material or part thereof.

  material

  According to one embodiment, the hip prosthesis comprises metal. It can be alloyed and can also be steel and / or biocompatible metals.

According to one embodiment, the percentage of martensite is higher in the first surface material or part thereof than in the second surface material or part thereof.

  It is also conceivable that the hip prosthesis consists of a polymeric material.

  In embodiments where the hip prosthesis comprises the first and second materials or parts thereof, it is conceivable that the first and second materials or parts thereof consist of metal. The metallic material or a portion thereof may be a metal selected from the group consisting of steel, steel alloys, titanium, titanium alloys, and biocompatible metals. In an embodiment in which the hip joint prosthesis comprises the first, second, third, fourth and fifth materials or parts thereof, the first, second, third, fourth and fifth materials or one of the first materials It is contemplated that all of the sections are metallic materials and that they are metals selected from the group consisting of steel, alloys of steel, titanium, titanium alloys, and biocompatible metals.

  Fixed area

  According to one embodiment, the hip prosthesis is attached for fixation to the femoral neck. In the above case, the prosthesis can be mounted so as to be fixed to the femoral neck inside it. In another embodiment, the hip prosthesis is attached for fixation to the femur. In the above case, it can be mounted to be fixed inside.

  Bonding area

  According to one embodiment, the bonding area comprises a ceramic material or a part thereof. It may be titanium carbide.

  Materials combined by net attraction

  According to one embodiment, the hip prosthesis comprises a first region and a second region coupled together by net attraction. The first region comprises a first material or a portion thereof attached to increase elasticity, and the second region comprises a second material or a portion attached to increase elasticity. The first material or a portion thereof is attached such that it is more resilient than the second material or a portion thereof.

  According to one embodiment, the hip prosthesis further comprises first and second ends located on the longitudinal axis of the hip prosthesis. The first end comprises a first material or part thereof and the second end comprises a second material or part thereof.

  According to one embodiment, when the hip prosthesis is implanted in the human patient, the proximal part of the hip prosthesis comprises the first end and the distal end of the hip prosthesis comprises the second end. It is also conceivable to consist of a department. It is also conceivable that the hip prosthesis gradually becomes more resilient from the second end to the first end.

  According to one embodiment, the hip prosthesis further comprises third, fourth and fifth regions. The third region comprises the third material or part thereof, the fourth region comprises the fourth material or part thereof, and the fifth region comprises the fifth material or part thereof. The first, second, third, fourth and fifth materials or parts thereof are bonded together with pure attraction.

  According to one embodiment, the first material or part thereof is attached so as to be more elastic than the second material or part thereof, and the second material or part thereof is from the third material or part thereof The third material or part thereof is attached to be more elastic than the fourth material or part thereof, and the fourth material or part thereof is a fifth material or It is attached in such a way that its elasticity is greater than a part of it.

  According to another embodiment, the first material or part thereof is attached to be more elastic than the second material or part thereof, the second material or part thereof is the third material or part thereof The third material or a part thereof is attached so as to be more elastic than the part, the third material or a part thereof is attached so as to be less elastic than the fourth material or a part thereof, and the fourth material or a part thereof is It is attached so that elasticity may become smaller than the said 5th material or its one part.

  According to another embodiment, the first material or part thereof is attached to be more elastic than the second material or part thereof, the second material or part thereof is the third material or part thereof The third material or part thereof is attached to be more elastic than the part, the third material or part thereof is attached to be more elastic than the fourth material or part thereof, and the fourth material or part thereof is It is attached so that elasticity may become smaller than the said 5th material or its one part.

  According to one embodiment, when implanting the hip prosthesis into the human patient, the first region is the most proximal region of the first, second, third, fourth and fifth regions, The second region is the second proximal region of the first, second, third, fourth and fifth regions, and the third region is the first, second, third, fourth and fifth regions. The third proximal region of the fifth region, the fourth region is the fourth proximal region of the first, second, third, fourth, and fifth regions, and the fifth region is the fifth region. The fifth proximal region of the first, second, third, fourth and fifth regions.

  According to one embodiment, the first material or part thereof is attached such that it is more elastic than the second material or part thereof, and the second material or part thereof is the third material or part thereof The third material or part thereof is attached to be more elastic than the fourth material or part thereof, and the fourth material or part thereof is It is attached so as to be more resilient than the fifth material or part thereof.

  According to one embodiment, the first material or part thereof is attached such that it is more elastic than the second material or part thereof, and the second material or part thereof is the third material or part thereof The third material or part thereof is attached to be less elastic than the fourth material or part thereof, and the fourth material or part thereof is It is attached so as to be less elastic than the fifth material or part thereof.

  According to one embodiment, the first material or part thereof is attached such that it is more elastic than the second material or part thereof, and the second material or part thereof is the third material or part thereof The third material or part thereof is attached to be more elastic than the fourth material or part thereof, and the fourth material or part thereof is It is attached so as to be less elastic than the fifth material or part thereof.

  The hip joint of a human patient consists of an acetabulum which is a bowl-shaped portion of the pelvis. According to any of the embodiments, the hip prosthesis further comprises a connecting area consisting of a connecting surface. The bonding surface comprises a first surface material having average elasticity or a portion thereof, the surface being attached for bonding with the acetabulum or an artificial substitute thereof. The prosthesis further comprises a fixation zone consisting of a fixation surface. The fixation surface comprises a second surface material or portion thereof having an average elasticity mounted to assist in the fixation of the hip prosthesis to the femur of the human patient.

According to one embodiment, the average elasticity of the first surface material or part thereof is lower than the average elasticity of the second surface material or part thereof.

  material

  According to one embodiment, the hip prosthesis comprises a metal, such as an alloy, in some cases steel, a biocompatible metal.

  According to one embodiment, the percentage of martensite is higher for the first surface material than for the second surface material.

  According to one embodiment, the hip prosthesis comprises a polymeric material.

  In embodiments where the hip prosthesis comprises the first and second materials, the first and second materials are considered to be metallic materials. The metallic material is a metal selected from the group consisting of steel, steel alloys, titanium, titanium alloys, and biocompatible metals.

  In another embodiment, the first, second, third, fourth and fifth materials are metallic materials, which are selected from the group consisting of steel, steel alloys, titanium, titanium alloys and biocompatible metals Metal that has been

  Fixed area

  According to one embodiment, the hip prosthesis is attached for fixation to the femoral neck, which may be performed from the inside.

  According to another embodiment, the hip prosthesis is attached to the femur for fixation, which may be performed from the inside. Combinations of the described alternatives are also conceivable.

  Bonding area

  According to one embodiment, the bonding area comprises a ceramic material such as titanium carbide. It is also conceivable that the material of the bonding area is a porous material.

  Curvature and Torsion: A hip prosthesis may consist of a fixation area, a connection area and an intermediate area placed between the fixation area and the connection area. The hip prosthesis, in any of the embodiments, elastically deforms when exposed to a force passing through an intermediate area mounted to curve with constant curvature when exposed to the force, or exposed to the force When exposed to a force passing through the middle area attached to twist when being flexed, or the middle area attached to bend and twist with a constant curvature when exposed to force It may be mounted to deform elastically when exposed to forces through it.

  According to one embodiment, the intermediate area is mounted to curve with a curvature of κ> 2. In another embodiment, the intermediate area is mounted to curve with a curvature of κ> 4. In yet another embodiment, the intermediate area is mounted to curve with a curvature of κ> 8. In the meantime, the fixation area is in a state of being fixedly attached to the femur.

According to one embodiment, the anchoring zone remains fixedly attached to the femur and the intermediate zone is mounted so as to be twisted until the twist angle (φ)> 0.005π. According to another embodiment, the intermediate area is mounted so as to twist until the twist angle (φ)> 0.01π. According to yet another embodiment, the fixation area remains fixedly attached to the femur while the intermediate area is mounted to twist until the twist angle (φ)> 0.02π. It is also conceivable that the anchoring zone remains fixedly attached to the femur, the middle zone being curved with a curvature of κ> 2 and mounted so as to twist to a twist angle (φ)> 0.005π.

  Methods: In any embodiment, there is further provided a method of absorbing force in the hip joint of a human patient using a hip joint prosthesis. The method comprises the step of elastically deforming the hip prosthesis, which when exposed to force elastically deforms the material of the first region of the hip prosthesis, and when exposed to the force The step of resiliently deforming the material of the second region of the hip prosthesis more than the material of the first region of the hip prosthesis.

  According to one embodiment, the material step of the first region of the hip prosthesis which elastically deforms when exposed to a force consists of the step of the material which elastically deforms more than the material of the femur. Also, the step of material of the second region of the hip prosthesis resiliently deforms smaller than the material of the first region of the hip prosthesis when exposed to force elastically with the material of the femur It consists of steps of material that deforms substantially equally.

  In yet another embodiment, the material step of the first region of the hip prosthesis that elastically deforms when exposed to a force comprises a step of the material that elastically deforms more than the material of the femur. On the other hand, the material step of the second region of the hip prosthesis, which elastically deforms smaller than the material of the first region of the hip prosthesis when exposed to force, is used to secure the hip prosthesis to the femur It consists of steps of bone cement and a material that elastically deforms substantially equally.

  According to one embodiment, the hip prosthesis comprises an anchoring area, a joining area and an intermediate area between the anchoring area and the joining area. The steps of a resiliently deforming hip prosthesis when exposed to force permanently attach the fixation area to the femur and ensure that the femur is not injured, but with a constant curvature when exposed to force It may consist of steps of a curved intermediate region or of a twisted intermediate region when exposed to force, or of a curved and twisted intermediate region when exposed to force.

  According to one embodiment, the intermediate area is curved with a curvature of κ> 2, in another embodiment the intermediate area is curved with a curvature of >> 4, and in yet another embodiment the intermediate area with a curvature of >> 8. To bend. During that time, the fixation area remains fixedly attached to the femur.

  According to one embodiment, the intermediate area is twisted until the twist angle (φ)> 0.005π, while the fixation area remains fixedly attached to the femur. According to another embodiment, the intermediate area is twisted until the twist angle (φ)> 0.01π, while the fixation area remains fixedly attached to the femur. In yet another embodiment, the intermediate area is twisted until the twist angle (φ)> 0.02π while the fixation area remains fixedly attached to the femur. It is also conceivable that the middle zone curves with a curvature >> 2 and twists until the twist angle (φ)> 0.005π, while the fixation zone remains fixedly attached to the femur. It is also conceivable that the middle zone curves with a curvature >> 2 and twists until the twist angle (φ)> 0.005π, while the fixation zone remains fixedly attached to the femur. It is also conceivable that the middle zone curves with a curvature >> 2 and twists until the twist angle (φ)> 0.005π, while the fixation zone remains fixedly attached to the femur.

  According to one embodiment, when implanted, the proximal portion of the hip prosthesis comprises the first end, while the distal end of the hip prosthesis comprises the second end. In addition, the hip joint prosthesis further has a hard upper portion and a less elastic layer on the surface of the first end.

  According to one embodiment, the upper part of the surface of the first end is lower / distal of the stiff and less elastic layer, the prosthesis becomes substantially more elastic and distally substantially elastic in the distal direction It will be smaller and smaller.

  According to one embodiment, the portion of the prosthesis that becomes substantially less resilient distally in the distal direction when implanted, ends where the distal prosthesis first contacts the femur.

  According to one embodiment, a portion of the prosthesis is placed in the femur which becomes more resilient distally distally when implanted.

  According to one embodiment, a portion of the prosthesis is placed on a femur that has elasticity close to that of bone.

  It should be noted that any embodiment, or part thereof, as well as any method or part thereof may be combined in some way.

In the example described by way of example with reference to the accompanying drawings:
Fig. 2 shows a side view of a human patient when performing a conventional hip surgery. Fig. 6 shows a front view of a human patient when an incision is made by surgery. FIG. 6A shows a front view of a human patient when an incision is made in a laparoscopic surgical procedure. Figure 1 shows an anterior view of a human patient and an instrument for a laparoscopic surgical procedure. The figure shows a human patient in the area when performing a laparoscopic surgical procedure. 1 shows a hip prosthesis according to one embodiment. 1 shows a hip prosthesis according to one embodiment. Fig. 2 shows a hip prosthesis according to one embodiment in detail. Fig. 2 shows a hip prosthesis according to one embodiment in detail. Fig. 6 shows a hip prosthesis according to one embodiment when fixed with a femur. Fig. 6 shows a hip prosthesis according to one embodiment when fixed at the femoral neck. 1 shows a hip prosthesis according to one embodiment. 1 shows a hip prosthesis according to one embodiment. Fig. 6 shows a hip prosthesis and its various parts. Fig. 6 shows a hip prosthesis having a curvature. It graphically illustrates how twist affects a portion of a hip prosthesis.

  Elasticity can be understood as the ability of a material to deform elastically.

Elastic deformation is that the material deforms under stress (eg, external force), but returns to its original shape when the stress is removed. Materials with high elasticity may be understood as materials with low elastic modulus. The elastic modulus of an object is defined as the slope of the stress-strain curve in the area of elastic deformation. The modulus of elasticity is calculated as stress / strain. Here, stress is the force causing the deformation, divided by the area to which the force is applied; and strain is the rate of change caused by the stress.

  Stiffness can be understood as the resistance of an elastic body to deformation due to an applied force.

  Net attraction can be understood as materials that are bonded together by atomic or molecular attraction. These net attraction forces include van der Waals forces, bipolar forces, or covalent forces. The materials to be bonded by net attraction include the same material, the same base material that has undergone different treatments, or different materials that are secured to one another with some type of bonding force.

  The proximal portion of the hip prosthesis may be understood as the proximally located portion in a human patient when implanted. Thus, the proximal part is the part consisting of the connecting area connected with the acetabulum. The distal portion is a prosthetic device located distal to a human patient when implanted. The distal portion comprises a fixation zone attached to secure the prosthesis to the femur and / or femoral neck.

  A portion of a material may be understood as a portion or area of material that does not necessarily have the same properties as other portions of the same material. For example, one part of the metallic material can be cured differently from the other parts of the metallic material, even though the two parts are part of the same basic material. The same is true for polymers and ceramic materials.

  Biocompatible materials are understood as materials with a low immune response. Biocompatible materials may also be referred to as biomaterials. Analogs are biocompatible metals with low immune response such as titanium or tantalum. The biocompatible metal can be a biocompatible alloy consisting of at least one biocompatible metal.

  A metallic alloy is understood as a mixture of two or more elements in solid solution whose main component is metal. Thus, a steel alloy is an alloy in which one of its components is steel. It may also be an alloy of iron and carbon. A titanium alloy is an alloy in which one of its components is titanium.

  Martensite is a very hard form of steel crystal structure, but it is also a crystal structure formed by displacement transformation. It comprises a class of hard minerals which occur as woody or plate-shaped grains.

  According to one embodiment, the hip prosthesis is a steel alloy prosthesis, such as a stainless steel prosthesis. Thus, one of the ends of the prosthesis is attached to couple with the acetabulum, which is the bowl-shaped part of the pelvis. The bonding area has a less elastic surface mounted to better resist wear than the other parts of the prosthesis. A less elastic surface is formed by quenching the surface, a process that rapidly heats the surface and then cools it. The quenching forms martensite on the surface, preventing carbon atoms from diffusing into the crystal structure. In addition, the prosthesis comprises a fixation zone which aids in the fixation of the prosthesis to the femur. The fixation zone may be only part of the prosthesis having a surface directly or indirectly coupled to the femur. In the above case, the prosthesis further comprises an intermediate area mounted so as to be located between the connection area and the fixation area. According to another embodiment, the anchoring zone is all of the prostheses remote from the bonding zone. The bonding area may be quenched by rapidly cooling that particular portion. However, it is also conceivable that the entire prosthesis is quenched and the areas not exposed to any wear are tempered to create a more elastic structure in the material.

  According to one embodiment, the bonding and anchoring zones are biocompatible metallic materials, while the intermediate zones are biocompatible polymeric materials such as polyurethane elastomeric materials, polyamide elastomeric materials, polyester elastomeric materials, and silicone materials .

  According to one embodiment, the hip prosthesis is a titanium or titanium alloy prosthesis and the bonding area consists of a ceramic layer such as titanium carbide to provide a highly wear resistant surface. Titanium or titanium alloy prostheses can be optionally tempered to make the material more resilient.

  The medical device according to any of the examples comprises at least one material selected from the group consisting of polytetrafluoroethylene (PTFE), perfluoroalkoxy (PFA) and fluorinated ethylene propylene (FEP). Further, the material is believed to be comprised of cobalt-chromium-molybdenum, or titanium, or metal alloys such as stainless steel, or polyethylene such as cross-linked polyethylene or gas-sterilized polyethylene. The use of ceramic materials such as zirconium or zirconium dioxide oxides or alumina ceramics for contact surfaces or all medical devices is also conceivable. The portion of the medical device in contact with human bone to secure the medical device to human bone has a porous microstructure attached to promote the ingrowth of human bone to the medical device to secure the medical device. Or it may consist of a poor house structure which is nanostructure. A porous structure can be achieved by applying a hydroxyapatite (HA) coating, or an atmospheric plasma spray coarse open pore titanium coating. Combinations of coarse open hole titanium coatings and HA top layers can also be considered. The contact portion is self-lubricating such as powder metallurgy material which can be injected using waxy polymers such as PTFE, PFA, FEP, PE and UHMWPE or lubricants (preferably biocompatible lubricants such as hyaluronic acid derivatives) It can be made from materials. It is also contemplated that the material of the contact portion or surface of the medical device may be mounted so that it can be lubricated constantly or intermittently. According to some embodiments, the component or part of the medical device is a combination of metal material and / or carbon fiber and / or boron, combination of metal and plastic material, combination of metal and carbon based material, carbon and plastic based It may be made of a combination of materials, a combination of flexible and rigid materials, a combination of elastic and less elastic materials, a Korean polymer or an acrylic polymer.

  A detailed description of the example is given below. In the drawings, numerals designate the same or corresponding elements throughout the several views as well as reference numerals. It should be understood that these numbers are for the purpose of illustration only and are not intended to limit the scope. Thus, reference to a direction such as "up" or "down" only refers to the direction indicated in the numbers. Also, all dimensions indicated by numbers are for illustrative purposes only.

  FIG. 1 shows a side view of a conventional hip surgery. Here, an incision 112 is made on tight 113 so that the operator can reach the femur 7 where the bone head 5 is present. In conventional hip surgery, the hip joint is evaluated through the joint capsule of the hip joint, which forces the operator to penetrate the joint capsule tissue.

  FIG. 2 shows a front view of a human patient's body when performing a surgical procedure that results in a hip prosthesis from the opposite side of the acetabulum. According to a first embodiment, the method starts with an incision 1 in the abdominal wall of a human patient. The incision 1 passes through the rectus rectus muscle and the peritoneum of a human patient and reaches the abdomen. In the second embodiment, the incision 2 is performed through the rectus abdominis muscle to the pelvic region under the peritoneum. According to the third embodiment, although the incision 3 is performed just between the iliac and the surrounding tissue, the incision 3 can excise the pelvis with little penetration of the fascia and muscle tissue. According to a fourth embodiment, the incision 4 is made in the inguinal channel. Remove or penetrate the tissue around the pelvis 9 in the opposite region of the acetabulum in all four examples. The operator can thereby reach the pelvis 9.

  FIG. 3 shows an anterior view of a human patient's body when performing a laparoscopic surgical procedure providing a hip prosthesis from the opposite side of the acetabulum. The method starts with making a small incision 14 in the abdominal wall of a human patient according to the first embodiment. A small incision allows the operator to insert a laparoscopic trocar into the abdomen of a human patient. According to a first embodiment, the incision 14 passes through the abdominal wall and the peritoneum into the abdomen of a human patient. According to a second embodiment, the small incision 15 passes through the abdominal wall (preferably rectus abdominis) to the subpelvic pelvic area. According to a third embodiment, a small incision 16 is made just between the iliac and the surrounding tissue. The incision 16 allows excision of the pelvis with little penetration of fascia and muscle tissue. According to a fourth embodiment, the incision 17 is made in the inguinal channel. In all four examples, the tissue around the pelvis 9 in the area opposite the acetabulum 8 is removed or penetrated. The operator can thereby reach the pelvis 9.

  FIG. 4 shows a front view of a human patient's body illustrating a laparoscopic surgical procedure to operate the hip joint from the opposite side of the acetabulum 8. The hip joint comprises an acetabulum 8 and a femoral head 5. Laparoscopic trocars 33a, b, c can be inserted into the patient's body through a small incision 14 in the abdominal wall of a human patient. Thereafter, one or more cameras 34, surgical tools attached for drilling holes in the pelvis 35, or tools 36 for introducing, installing, combining, attaching, producing or filling the prosthesis or parts thereof are concerned. It can be inserted into the body through the laparoscopic trocars 33a, b, c.

  FIG. 5 shows a side view of the human patient's body detailing the hip joint in the area. The hip joint consists of the femoral head 5 at the very top of the upper femur, which is the upper part of the femur 7. The femoral head is connected to an acetabulum 8 which is a bowl-shaped portion of the pelvis 9. The laparoscopic trocars 33a, b, c introduce, place, attach, attach, create, or create one or more cameras 34, surgical tools attached to the pelvis 35 for drilling, or prostheses or parts thereof. It is used to guide the filling tool 36 to the hip joint 39.

  FIG. 6 shows a hip prosthesis in accordance with an embodiment where the hip prosthesis is attached for fixation to the femur using the fixation area A. The hip prosthesis is mounted so as to have the areas indicated schematically by A, B, C and D. The areas are mounted to have different characteristics. According to one embodiment, area A is mounted to be less elastic than area B, and area B is then mounted to be less elastic than area C. Furthermore, the area C is attached so as to be less elastic than the area D. This allows the first area A to be firmly fixed to the femur, and the hip prosthesis to absorb the impact of movement and load of the human patient through the area of greater elasticity. According to another embodiment, the area A is mounted to be less elastic than the area B, and then the area B is less elastic than the area C, but more elastic than the area D. It is attached. This allows the first area A to be firmly fixed to the femur and the hip prosthesis to absorb the impact while at the same time by making the connection area D contact the acetabulum 8 or its artificial substitute Can resist the resulting wear. However, in any of the embodiments, it is also contemplated that the artificial femoral head surface 45 may be comprised of a surface material such as a less elastic metallic material, ceramic material, carbon material, or polymer material attached to resist wear. Be

  FIG. 7 shows a hip prosthesis in accordance with an embodiment for fixing the hip prosthesis to the femoral neck using the fixation area A. The hip prosthesis consists of three sections, schematically indicated by A, B and C. According to one embodiment, area A is mounted to be less elastic than area B, and area B is then mounted to be less elastic than area C. This allows the first section A to be firmly fixed to the femoral neck, while at the same time the hip prosthesis can absorb the impact of the movement and load of the human patient through the section of greater elasticity. According to one embodiment, area A is mounted to be less elastic than area B, and area B is then mounted to be more elastic than area C. This allows the first area A to be firmly fixed to the femoral neck, and the hip prosthesis can absorb the impact, while at the same time the connection area C being in contact with the acetabulum 8 or its artificial substitute Can resist the resulting wear. However, in any of the embodiments, it is also contemplated that the artificial femoral head surface 45 may be comprised of a surface material such as a less elastic metallic material, ceramic material, carbon material, or polymer material attached to resist wear. Be

  FIG. 8 shows one embodiment of the hip prosthesis, which comprises several sections, the hip prosthesis being schematically indicated by I-XI. According to this embodiment, the hip prosthesis is made of metallic material, which is hardened so that different areas can have different properties. The curing process can be performed such that distinct areas with different properties can be present. However, it is also conceivable that the different characteristics are continuously observed on the hip prosthesis, in other words without clear boundaries, and that the various characteristics are continuous throughout the hip prosthesis. However, hip prostheses consist of areas adapted for different surgical purposes. The fastening zone A preferably comprises a zone of small elasticity I-XI. This is because the ability to fixate the hip prosthesis firmly to the femur is advantageous to a hip prosthesis that does not change shape dramatically. Areas B and C preferably consist of areas of high elasticity I-XI. This is because this part of the hip prosthesis can be reshaped without dramatically affecting the mechanical function of the hip prosthesis. The joint area D, consisting of the artificial femoral head surface 45, is separated from the area of the metallic material, which is attached for less elasticity and higher resistance to wear, or from the rest of the hip prosthesis. Preferably, it consists of a surface material mounted so as to resist the wear brought about by the connection with the acetabulum or its artificial substitute. According to another embodiment, the material is a polymeric material that is hardened and stretched to provide different properties in different areas of the hip prosthesis. According to another embodiment, the hip prosthesis is made of a ceramic or powder based material. In this case, the hip prosthesis can be hardened or sintered so that the different areas extending along the longitudinal axis L of the hip prosthesis also have different properties.

  FIG. 9 shows the hip prosthesis in an embodiment consisting of several sections, schematically represented by I-VII. According to this embodiment, the hip prosthesis is metallic and the metal is hardened so that different areas have different properties. The curing process can be performed such that distinct areas with different properties can be present. However, it is also conceivable that the different properties of interest are continuously observed in the hip prosthesis, in other words that the various properties are continuous without clear boundaries throughout the hip prosthesis. However, hip prostheses consist of areas adapted for different surgical purposes. The fastening zone A preferably consists of a zone of small elasticity I-VII. This is because the ability to firmly fix the hip prosthesis to the femoral neck 6 is advantageous with a hip prosthesis that does not change shape dramatically. It is preferable that the area B consists of an area of the highly elastic area I-VII. Because this part of the hip prosthesis can change its shape without dramatically affecting the mechanical function of the hip prosthesis. The joint area C comprising the artificial femoral head surface 45 is separated from the area of the metallic material, which is attached so as to be less elastic and more resistant to wear, or other parts of the hip prosthesis, It is preferred that the surface material be attached so as to resist the wear caused by the combination with the die or its artificial substitute. According to another embodiment, the material is a polymeric material that is hardened and stretched to provide different properties in different areas of the hip prosthesis. According to another embodiment, the hip prosthesis is made of a ceramic or powder based material. In this case, the hip prosthesis can be hardened or sintered to have different properties in different areas extending along the longitudinal axis L of the hip prosthesis.

  FIG. 10 shows the hip prosthesis when it is fixed to the femur 7. According to this embodiment, the hip prosthesis is mounted for fixation on both the femur 7 and the femoral neck 6. According to this embodiment, the anchoring zone A of the hip prosthesis consists of the majority of the hip prosthesis. On the other hand, the part B attached so as to increase the elasticity to absorb the shocks and vibrations brought about by the movement of the human patient is rather short as shown in the figure.

  FIG. 11 shows the hip joint in the area of the embodiment in which the hip joint prosthesis attached to be fixed to the femoral neck according to the above embodiment is attached to the hip joint through the hole 18 of the pelvis 9. According to this embodiment, the hip joint prosthesis supports the hip joint prosthesis from the outside of the femoral neck 6 through the connection with the surface of the area 614 of the femoral neck 6 and from the acetabular side of the femoral neck 6 It consists of a member 612.

  FIG. 12 shows a hip prosthesis according to an embodiment, wherein the hip prosthesis comprises a less elastic core structure 615 and a more elastic surface structure 616. The hip prosthesis can be made of a metallic material attached to harden in different steps, ie from the outside and inside, so that the surface structure has different properties than the core area 615. Also, for example, the hip joint prosthesis, so that the anchoring zone A, which attaches the hip joint prosthesis so as to anchor it to the femur 7, consists of a relatively large part of the less elastic core material 615 supporting the fixation of the hip joint prosthesis in the femur It is also possible to vary the thickness of the surface area along the extension of the. Equally, it is preferable that the areas B and C can be mounted in such a way that their elasticity is increased so as to be able to absorb the shocks and vibrations caused by the movement of the human patient. The hip prosthesis can be separated into a highly elastic surface area 616 and a small elastic core area using well-defined areas. However, it is also conceivable that this separation is made continuously, in other words without a clear boundary between the core area 615 and the surface area 616.

  FIG. 13 illustrates a hip prosthesis according to an embodiment in which the hip prosthesis comprises a less elastic core structure 615 and a more elastic surface structure 616. The hip prosthesis can be made of a metallic material attached to harden in different steps, ie from the outside and inside, so that the surface structure has different properties than the core area 615. Also, for example, the hip joint so that the anchoring zone A, which attaches the hip prosthesis to the femoral neck 6, for example, consists of a relatively large portion of the less elastic core material 615 supporting the anchoring of the hip prosthesis in the femur. The thickness of the surface area can also be varied along the extension of the prosthesis. Similarly, it is preferable that the areas B and C can be mounted with great elasticity so as to be able to absorb the shocks and vibrations brought about by the movement of the human patient. The hip prosthesis can be separated into a highly elastic surface area 616 and a small elastic core area using well-defined areas. However, it is also conceivable that this separation is made continuously, in other words without a clear boundary between the core area 615 and the surface area 616.

  FIG. 14 shows the hip joint prosthesis C with a fixation area A ′, a joint area C extending around the prosthetic femoral head portion 45 of the hip joint prosthesis, and an intermediate area B between the fixation area A ′ and the joint area C. Fig. 6 shows an example of a hip prosthesis comprising '. The fixation area is attached to the inside of it so as to be fixed to the femur. The fixation area A 'is used to secure the femur and / or hip prosthesis to the femur, in conjunction with the femur and moved together, thereby reducing the risk of femoral fracture or prosthetic relaxation. It can be made of a material that has the same elasticity as bone cement. According to one embodiment, the bonding area C consists of a surface material which is less elastic than the core material of the bonding area C in order to improve the wear resistance to the acetabulum or its artificial substitute. It is generally considered that the anchoring zone A ', the bonding zone C and the middle zone B' can consist of materials having different elastic moduli or parts thereof. The hip prosthesis has a change in the extension of the hip prosthesis and / or changes perpendicular to the extension, in other words as a core of a hip prosthesis having one elasticity and a hip prosthesis having one elasticity It is also conceivable to consist of different materials in one area as the surface of the organ.

  FIG. 15 shows a hip prosthesis according to an embodiment in which the hip prosthesis is mounted to absorb the force of the hip joint through the elastically deforming hip prosthesis when exposed to a force. According to the embodiment shown in FIG. 15, the anchoring zone A ′ ′ of the prosthesis consists of a material or part thereof that is attached to elastically deform when exposed to a force.

  Also, the middle section B "of the hip prosthesis consists of a material or part thereof that is elastically deformed to a greater extent than the material of the fixed section A". The middle section B "of the hip prosthesis is mounted to absorb forces through the middle section of the curve having a curvature value = 1 = 1 / R, where R is the radius of the contact circle at point P on the curve According to one embodiment, with the fixation area A ′ ′ fixedly attached to the femur and the femur intact, the hip joint prosthesis processes a curved intermediate area with a curvature value κ> 2 Mounted so that you can do it. According to another embodiment, with the fixation area A ′ ′ still fixedly attached to the femur and the femur intact, the hip prosthesis has a curved intermediate area with a curvature value κ> 4. In yet another embodiment, with the fixation area A ′ ′ fixedly attached to the femur and the femur intact, the hip prosthesis has a curvature value It is mounted in such a way that it can handle curved intermediate areas with κ> 8. The above embodiments can all be carried out through an intermediate section B "of an elastic material which absorbs the force sufficiently without damaging the femur, or by combining the femur and the hip prosthesis.

Further, the hip prosthesis of FIG. 15 is mounted to absorb the force of the hip joint through the resiliently twistable intermediate area B ′ ′. The ability to absorb twist by twisting causes a constant force to be applied, The material is defined as an angle or twist angle = the ability to twist ね じ According to the example, the hip prosthesis remains fixedly attached to the fixation area A "to the femur and the femur is intact. , Twist angle .phi.> 0.005.pi. Radians is mounted so as to be able to handle an intermediate area B ". According to another embodiment, the hip prosthesis remains fixedly attached to the femoral area A". Also, with the femur intact, it is mounted to be able to handle an intermediate area B ′ ′ that twists a twist angle φ> 0.01π radians. In yet another embodiment, the hip joint prosthesis comprises an anchoring area A Is fixedly attached to the femur, and the femur is mounted intact so that it can handle an intermediate area B ′ ′ where the twist angle φ> 0.02π radians twist. The twist angle is shown in FIG. The above embodiments can all be carried out through the middle section B "made of an elastic material which absorbs the force sufficiently without damaging the femur, or by combining the femur and the hip prosthesis.

  The hip prosthesis according to any of the embodiments may be mounted to be resiliently curved or resiliently twisted or resiliently curved and twisted. In addition, the hip prosthesis according to any of the embodiments may be as resiliently twisted as the femur and / or as a bone cement used to secure the femur and / or the hip prosthesis to the femur. It can be considered to attach it to be elastically curved.

  The anchoring zone according to any of the embodiments can be made of a porous or partially porous material to improve the growth of bone tissue anchoring the prosthesis. The porous material allows the bone tissue to expand into the prosthesis and provide a stable fixation.

Note that any embodiment, or part of an embodiment, and any method or part of a method can be combined in any way. All the examples described here are part of the general description and can therefore be combined in any way under the general conditions.

Claims (1)

  A hip prosthesis implanted in a patient's hip, the hip prosthesis having a longitudinal axis extending proximally when implanted, the hip prosthesis having a first proximal Having a region and a second proximal region, the first proximal region comprising a portion of a first resilient first material, and the second proximal region a second It comprises a part of the material having the determined elasticity, and the first material has elasticity different from that of the second material, and the difference in elasticity between the two materials causes the hip joint artificial along the longitudinal axis. A hip prosthesis characterized in that it affects the elasticity of an organ.